DefinePK

Abstract

Background: Acute bronchiolitis is an acute viral respiratory illness that occurs in infants and that manifests through inflammation and obstruction of the bronchioles. HS is thought to increase mucus transport while NS with salbutamol is aimed to reduce bronchoconstriction in patients. Information about the relative effectiveness of these treatments enhances patient care within a hospital. Objectives: To determine whether treatment with hypertonic saline is superior to treatment with normal saline and salbutamol in children with acute bronchiolitis when assessed clinically, in terms of time to clinical improvement, length of hospital stay and total recovery time. Study design: A quasi experimental study. Place and duration of study:  Department of Pediatrics Ayub Teaching Hospital from September 2024 to February 2025. Methods: A quasi experimental study on 120 infants with acute bronchiolitis. Of these, sixty patients were given nebulized 3% hypertonic saline and sixty were given normal saline plus salbutamol. Evaluation of clinical effectiveness was done through respiratory distress scoring and overall days on treatment. Data were analyzed descriptively using mean and standard deviation to compare the two groups and inferential using p-value to test for significant difference between the two groups. Results: The HS group of patients were discharged after a mean hospital stay of 2.8 ± 0.5 days from the time of admission while the normal saline + salbutamol group was discharged after a mean hospital stay of 3.5 ± 0.7 days the results show that the hypertonic saline treatment group reduced their hospital stay duration by 20%. Significant improvement was noted in severity of clinical signs in hypertonic saline group i.e. 85% and in normal saline + salbutamol group i.e. 65% (p-value < 0.05). The mean reduction in respiratory distress scores was a more pronounced 30% in patients who received hypertonic saline compared to a 18% reduction in the normal saline + salbutamol arm (p = 0.03). These results suggest statistically significant enhanced respiratory status and, consequently, shorter length of hospital stay for patients who received hypertonic saline. Conclusions: Our previous study showed that hypertonic saline was superior to normal saline with salbutamol in decreasing the length of hospital stay and the severity of respiratory symptoms of acute bronchiolitis in infants. This leads to the conclusion that HS could be the preferred modality of treatment for bronchiolitis in tertiary care settings.